This study was designed to determine the feasibility of spirometry and to determine its usefulness in confirming the diagnosis in patients hospitalized with a physician diagnosis of asthma or chronic obstructive pulmonary disease exacerbation. It found that confirmatory spirometry was a useful tool to help reduce overdiagnosis of obstructive lung disease, especially among obese patients.

The authors are concerned that an undue emphasis on one-way information transfer during handoffs of hospitalized patients can lead to research designs and policy recommendations that fail to recognize the active participation of both parties in co-constructing the oncoming caregiver's understanding of the patient. They present some of the findings from research outside medicine that support and refine this idea.

The purpose of this study was to compare those who and those who do not conduct self-monitoring of blood glucose (SMBG) as recommended with respect to patient demographics, self-care behaviors, barriers to SMBG, and purchase of blood-glucose testing supplies. Twenty of the 42 participants reported testing their blood glucose one or more times a day while 7 had their blood glucose tested only when they were at their physician's office.

The researchers sought to demonstrate channeling among new users of second-generation antipsychotics following an FDA safety advisory and to evaluate the impact of channeling on cardiovascular risk estimates over time. They found that changes in channeling had limited impact on cardiovascular risk estimates, possibly due to unmeasured confounding factors.

The objectives of this study were to identify utilization patterns and estimate health plan payments for inpatient, outpatient, and pharmacy services among privately insured children with bipolar disorder diagnoses. The researchers found that the costs of care among this population are similar to those for adults. However, spending on children is concentrated on mental health-related services.

The researchers undertook a pilot study to examine the feasibility of (1) conducting interdisciplinary fall risk screens at a communitywide adult fall prevention event and (2) collecting preliminary follow-up data about the balance confidence of adults screened at the event, as well as home or activity modifications they made after receiving educational information at the event. They found that screening conducted in this context is feasible and can facilitate environmental and behavior changes to reduce fall risk.

This article describes recent research to determine why some organizations are more successful than others in reducing central line-associated bloodstream infections (CLABSIs). In case studies at nine hospitals involving interviews with 226 clinicians and administrators, researchers identified some keys to successful efforts. These included strong, visible clinical leadership; systematic approaches to training; a belief that zero CLABSIs is achievable; more pervasive information sharing; a greater sense of personal accountability; and an eye toward sustainability.

These authors investigated the influence of ethnicity on older American Indian patients' interpretations of providers' affective behaviors. Using data from 115 older American Indian patients, the researchers found that in models accounting for patients' ethnicity only, high scores for American Indian ethnicity were linked to reduced evaluations for providers' respect. High scores on white ethnicity were associated with elevated ratings for empathy and rapport.

The AcademyHealth Electronic Data Methods Forum aims to advance the national dialogue on the use of electronic clinical data (ECD) for comparative effectiveness research (CER) by facilitating exchange and collaboration among 11 research projects and external stakeholders. To this end, AcademyHealth conducted a mixed-method needs assessment with the forum's key stakeholders to assess stakeholder views on developing new infrastructure for CER using ECD.

This study examined national rates of suicidal ideation, plans, and attempts in the past year among a large, nationally representative sample of adolescents. During 12 months, 3.6 percent of adolescents reported suicidal ideation without a plan or attempt, and 1.9 percent made a suicide attempt. Most of those in either category did not have any contact with a mental health specialist in the past year.

The researchers examined the prevalence, reliability, and predictors of conflict of interest (COI) and funding disclosure statements for studies of anticancer targeted therapies conducted in the off-label prescribing setting. They found that disclosure of potential sources of bias in COI and funding statements was low and did not increase substantially over time.

The purpose of this literature review is to summarize the existing occupational therapy-related fall prevention literature in order to develop information on occupational therapy's current involvement in these efforts and offer suggestions for future opportunities for occupational therapy in fall preventions for community-dwelling older adults.

This article summarizes the key findings of the AHRQ 2011 Comparative Effectiveness Review (CER), which describes the efficacy and harms of off-label uses of atypical antipsychotics, updated from the 2006 AHRQ CER report. Scientific literature on the utilization, efficacy, adverse effects, dosing, and treatment duration on patient outcomes is reviewed in order to inform prescribing decisions. Applications of the AHRQ findings to practice are discussed to provide clinicians information to support evidence-based care for their patients.

The study evaluated the performance of the Self-Administered Comorbidity Questionnaire (SCQ) to predict functional capacity and quality of life health outcomes compared to Charlson Comorbidity Index (CCI) medical records data in the same patients. The patients were admitted to the hospital with a diagnosis of acute coronary syndrome. The results showed that the self-report SCQ index is a good alternative method to predict quality of life health outcomes when compared to a CCI medical record score.

The researchers developed and implemented a cardiovascular perfusion registry to improve understanding of the practice of cardiopulmonary bypass within the setting of a regional cardiovascular surgical collaborative (Michigan Society of Thoracic and Cardiovascular Surgeons [MSTCVS]). They were able to successfully and accurately collect data on cardiovascular perfusion among 14 institutions in conjunction with the MSTCVS.

The researchers explored the relationship between diagnosis of serious mental illness and subsequent new diagnoses of HIV in a Medicaid population in 8 States. After substance abuse or dependence was controlled for longitudinally, little independent association between serious mental illness and the risk of new HIV diagnoses was found.

The primary objective of this systematic review was to compare management strategies for adults with asymptomatic carotid artery disease. The secondary objective was to evaluate contemporary stroke rates in studies evaluating medical therapy alone. The review of 47 studies found that evidence was neither sufficiently robust for carotid artery stenting nor applicable to current clinical practice for carotid endarterectomy to determine the comparative effectiveness of management approaches for adults with asymptomatic carotid stenosis.

The researchers evaluated eligibility and participation in the Medicare Part D Low-Income Subsidy (LIS) by enhancing the reliability of the Medicare Current Beneficiary Survey financial information. They used unpublished survey data on income and assets together with an income imputation procedure. They found an LIS take-up rate of 30 percent among those who were not auto-enrolled. Also, the majority of LIS-eligible nonenrollees obtained unsubsidized drug coverage.

The researchers evaluated the impact of systematic reviews on research funded by AHRQ through Evidence-based Practice Centers (EPCs) to identify barriers to and facilitators of the effects of these documents on future research. They concluded that AHRQ and the EPCs may be able to improve the likelihood of impact by creating more targeted products, planning for and expanding dissemination activities, improving the readability and other attributes of the reports themselves, and actively involving funders early on and throughout the process of creating and publishing the reviews.

The researchers examined the association between accreditation and select measures of quality in U.S. nursing homes. Comparing quality in the year before accreditation by the Joint Commission with the first year after accreditation, all five quality measures and both five-star categories demonstrated improvement. After 8 years of accreditation, three of the quality measures continued to improve. There were no cases where accreditation was associated with decreased quality.

The few existing economic studies cannot serve as a strong evidence base for guiding effective formulation of national suicide prevention strategies. The author makes a series of recommendations for improving the scientific evidence base to support more effective formulation and implementation of suicide prevention strategies, using economic analyses to maximize scarce resources.

Page last reviewed October 2013Page originally created October 2013

Internet Citation: Research Briefs. Content last reviewed October 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/research-activities/13oct/1013ra25.html